Methamphetamine use in trauma patients: A population-based study

Background: There are indications that methamphetamine production and illic it use are increasing. We investigated the epidemiology of methamphetamine use in trauma patients in an area of heavy methamphetamine prevalence. Study Design: This was a retrospective population-based review. We reviewed toxicology and alcohol test results in trauma patients admitted to the Uni versity of California, Davis, between 1989 and 1994 to the only trauma cent er serving a population of 1.1 million. Results: Positive methamphetamine rates nearly doubled between 1989 (7.4%) and 1994 (13.4%), compared with a minimal increase in cocaine rates (5.8% t o 6.2%) and a decrease in blood alcohol rates (43% to 35%). Methamphetamine -positive patients were most likely to be Caucasian or Hispanic; cocaine-po sitive patients were most likely to be African American. Methamphetamine-po sitive patients were most commonly injured in motor vehicle collisions or m otorcycle collisions; cocaine-positive patients were most commonly injured by assaults, gunshot wounds, or stab wounds. Cocaine positivity and alcohol positivity predicted a decreased need for emergency surgery and cocaine po sitivity predicted a decreased need for admission to the ICU. Conclusions: Methamphetamine use in trauma patients increased markedly in o ur region between 1989 and 1994, alcohol rates decreased, and cocaine rates remained unchanged. Methamphetamine-positive patients had mechanisms of: i njury similar to those of alcohol-positive patients, so injury prevention s trategies for methamphetamine should be patterned after strategies designed for alcohol. (J Am Cell Surg 1999;189:442-449. (C) 1999 by the American Co llege of Surgeons).